Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

Sanzo says he gambles for fun and enjoys the friends he’s made among other regulars at the casino since leaving his job installing signs for the state highway department.

“I’m retired, and it exercises my brain,” he says.

He’s an example of what a surprising Yale University study found — older recreational gamblers seem to be healthier than non-gamblers.

The findings are not rock-solid. They’re only based on telephone interviews, but the results are the opposite of what researchers expected. The survey showed that recreational gamblers 65 and older reported being in better health than their peers who don’t gamble. The older gamblers also reported less alcoholism, depression, bankruptcy and imprisonment than younger recreational gamblers, Yale epidemiologist Rani Desai said.

Desai cautioned that more study is needed to conclude that gambling can be a healthy venture, and those who help gambling addicts are skeptical.

But the social aspects of gambling — whether it’s slot machines at a casino, poker games with friends or bingo at a church hall — may be an explanation for how the study turned out, Desai said.

“There’s this whole concept of healthy aging — that folks who continue to remain engaged in activity, especially in the community and in social activities, stay healthier longer, so I think this is a reflection of that. It’s not that gambling makes you healthy, it’s that gamblers are healthier,” Desai said.

Some psychologists question the findings.

“It may get them out, but the socialization isn’t that much because they sit in front of machines, interacting with them,” said psychologist Elizabeth Sterling of Santa Fe, N.M., who counsels gambling addicts. “I guess if you can keep it at a limit — spend $20 and go once a week — there’s no harm to it, but a benefit I can’t see.”

Desai started the study with the idea that health problems already well documented among all gamblers might be more pronounced in gamblers over 65. Any losses would presumably hit older people harder, since most are on fixed incomes.

Also, the gambling industry tries to attract older people with freebies and trips, and even provide needle disposals for diabetics in the restrooms and heart defibrillators on the casino floor.

The survey of 2,400 people relied on the participants to report their gambling habits, health and other personal information. A survey firm called all the participants, and Yale researchers crunched the numbers. The findings were published in the September issue of the American Journal of Psychiatry.

The results could be because nongamblers might be too ill or disabled to leave the house, but there also are plenty of older people with health problems at the track and the blackjack tables.

Moderation is keyJoe Haley, 71, of Colchester, uses an oxygen tank because he has a rare lung disease, but he still goes to Mohegan Sun about once a month for video poker and blackjack.

“My opinion is a lot of people are lonely and a lot of people we know who come here will tell you that. They like to play a little and chitchat with the person next to them,” Haley said.

Sanzo, the retired state highway worker, had heart bypass surgery a few years ago. He and his wife, who live in the Hartford suburb of Newington, visit the Mohegan Tribal Nation’s casino a few times a week. They spend about $40, pursuing their separate gambling interests, and meet up later to compare notes on how they did.

The study only looked at recreational gamblers and did not study people who had gambling problems. Very few were found in the survey, Desai said, but the health and financial problems for addicts are well known.

“The key is moderation, and once it gets to the point that you’re showing signs of addiction, then it becomes a serious health threat and is overwhelmed by any small benefit it may have afforded you by getting out of the house,” she said.

Keith Whyte, the executive director of the National Council on Problem Gambling, which advocates for gambling addicts, likened the Yale report to studies that have found a glass of red wine can be healthful.

He recommended that recreational gamblers should set limits, go with friends, take breaks and know the signs of addiction, such as betting increasing amounts to enjoy gambling as much, out-of-control feelings or allowing gambling to interfere with work, family or school. Gamblers also should know who to contact if they need help.

“Clearly, if it becomes obsessive and a psychological health problem,” he said, “that’s a concern for everybody.”